Adverse Event Reporting
| VAERS ID | 2014296 |
|---|---|
| Gender | Female |
| Age | 72 |
| StateCode | NJ |
| Pharmaceutical Company | MODERNA |
| Lot Number | 071F21A |
| Number of vaccinations | 3 |
| Vaccinated | 2021-10-01 |
| Onset | 2021-12-30 |
| Condition | Hospitalized Died |
Symptoms
- SARS-CoV-2 test positive
- Underdose
- COVID-19
- Death
Current Illness
Preexisting Conditions
non alcoholic liver cirrhosis, pancytopenia, GI bleed
Other Medications
Previous Vaccinations
Allergies
Laboratory Data
Covid-19 Positive 12/30/2021
Write-up
Covid #1 given on 2/15/2021, #2 on 3/15/2021 and boosted on 10/31/2021.
Boosted was with 0.
25 mL and not 0.
5, which would have been more appropriate for an immunocompromised patient.
Booster dose given at Pharmacy.
Patient admitted to hospital on 12/30/2021 and expired on 1/6/2022 Tested positive for Covid-19 on admission